# PLAB 1 Obstetrics & Gynaecology Questions: 10 Free Practice MCQs > 10 free PLAB 1 obstetrics & gynaecology questions with answers and explanations, from a bank of 331 obstetrics & gynaecology questions. Try them now, no… Canonical: https://medhub.one/practice/plab-1/obstetrics-gynaecology Last updated: 2026-10-29 Ten PLAB 1-style obstetrics & gynaecology questions with the answer and the reasoning behind it. They come from the UK.med bank, which has 331 obstetrics & gynaecology questions and many more across every topic. 1. 1 / 10 A 23-year-old taking a combined oral contraceptive presents with light contact bleeding. Speculum examination shows a smooth, red, everted area around the cervical os. There is no discrete polyp, ulceration or irregular mass. What is the most likely diagnosis? Show answer **Answer: D.** Cervical ectropion. **Why:** This is cervical ectropion, a benign exposure of columnar epithelium on the ectocervix that can cause contact bleeding. It is associated with oestrogen and combined hormonal contraception. A suspicious or persistent unexplained symptom still requires appropriate clinical assessment. * **A.** Endometrial cancer is very unlikely at this age and usually presents with uterine bleeding rather than a characteristic cervical finding. * **B.** An irregular or ulcerated mass would be more concerning for cancer than the symmetric appearance described. * **C.** A polyp is a discrete lesion that projects from the cervical canal. Sources: NHS, Cervical ectropion; NICE NG12, Suspected cancer: recognition and referral 2. 2 / 10 A 28-year-old woman with irregular periods and BMI 32 is struggling to conceive. Ultrasound shows multiple peripheral follicles. What is the most likely diagnosis? Show answer **Answer: A.** Polycystic Ovary Syndrome (PCOS) **Why:** This patient meets the Rotterdam criteria for PCOS, requiring at least 2 of 3 features: oligo/anovulation, hyperandrogenism, and polycystic ovarian morphology. Premature ovarian insufficiency presents with elevated FSH and depleted follicles. Hyperprolactinaemia typically causes galactorrhoea and amenorrhoea without polycystic ovaries. Hypothalamic amenorrhoea is usually triggered by low BMI or stress. * **B.** Would show low follicle count and high FSH. * **C.** Causes amenorrhoea but not typical US ovary appearance. * **D.** Usually associated with low BMI/stress. Sources: RCOG Green-top Guidelines 3. 3 / 10 A 17-year-old is 3 years past menarche and has had only three periods in the past year. She has progressive facial hirsutism and acne, and blood tests show raised total testosterone. Pregnancy, thyroid disease and hyperprolactinaemia have been excluded. What is the most likely diagnosis? Show answer **Answer: A.** Polycystic ovary syndrome presenting with ovulatory dysfunction and hyperandrogenism. **Why:** In adolescents, PCOS should be considered when persistent ovulatory dysfunction is accompanied by clinical or biochemical hyperandrogenism after alternative causes are excluded. Polycystic ovarian morphology on ultrasound should not be used to diagnose PCOS in adolescents. The history here supplies the two relevant features and excludes common mimics. * **B.** Ovarian insufficiency would more often cause raised FSH and reduced oestrogen rather than androgen excess. * **C.** There is no history of energy deficit, and hypothalamic amenorrhoea does not explain progressive hirsutism with raised testosterone. * **D.** Turner syndrome usually presents with impaired pubertal development and ovarian insufficiency, not hyperandrogenism. Sources: International evidence-based guideline for PCOS, Monash University, 2023; NICE CKS, Polycystic ovary syndrome 4. Like these? 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Risk factors include age >=35, BMI >=30, smoking, parity >=3, gross varicose veins, and pre-eclampsia. A risk score of >=4 warrants immediate LMWH. A score of 3 warrants LMWH from 28 weeks. A score of >=2 postpartum warrants LMWH for 10 days postpartum. Since this patient has 3 risk factors (age 37, BMI 32, smoking), she starts LMWH at 28 weeks and continues for 6 weeks postpartum. * **A.** A score of 2 requires postpartum LMWH for 10 days, but her score is 3 due to age, BMI, and smoking, which warrants antenatal LMWH from 28 weeks. * **B.** A score of >= 4 warrants LMWH immediately from booking, but she only has 3 risk factors, so she starts at 28 weeks. * **D.** She has multiple risk factors (age, obesity, smoking) and requires active pharmacological prophylaxis, not conservative care. Sources: RCOG Green-top Guideline No. 37a: VTE Prophylaxis in Pregnancy 6. 5 / 10 A 32-year-old at 16 weeks' gestation has chronic hypertension previously controlled with ramipril. Her blood pressure is now 148/94 mmHg after ramipril was stopped. She has no contraindication to labetalol. Which antihypertensive is the most appropriate option to start? Show answer **Answer: C.** Start labetalol, titrating treatment towards a blood pressure of 135/85 mmHg. **Why:** Her blood pressure exceeds the threshold for treatment of chronic hypertension in pregnancy. NICE advises stopping ACE inhibitors and offering an alternative; labetalol is an option when suitable, with a target of 135/85 mmHg. Treatment should not be delayed until severe-range readings occur. * **A.** ACE inhibitors should be stopped in pregnancy and an alternative offered. * **B.** Atenolol is not NICE's preferred first-line option for chronic hypertension in pregnancy. * **D.** NICE recommends treating chronic hypertension from sustained 140/90 mmHg, not waiting for severe hypertension. Sources: NICE NG133, Hypertension in pregnancy: diagnosis and management, recommendations 1.3.3 and 1.3.8 to 1.3.10, 2019 7. 6 / 10 A 30-year-old at 15 weeks' gestation has known chronic hypertension. Her blood pressure is 150/96 mmHg, and she stopped ramipril after a positive pregnancy test. She has no contraindication to labetalol. What is the most appropriate medication to use for blood pressure control? Show answer **Answer: A.** Labetalol, with dose adjustment to reach a target of 135/85 mmHg. **Why:** The patient's blood pressure exceeds the threshold for treatment of chronic hypertension in pregnancy. Labetalol is a NICE treatment option when suitable, with a target of 135/85 mmHg. Ramipril is inappropriate in pregnancy, and aspirin prophylaxis does not replace antihypertensive treatment. * **B.** ACE inhibitors should be stopped in pregnancy and an alternative offered. * **C.** Chronic hypertension should be treated at sustained pressure of 140/90 mmHg or higher. * **D.** Aspirin is used to reduce pre-eclampsia risk; it is not an antihypertensive. Sources: NICE NG133, Hypertension in pregnancy: diagnosis and management, recommendations 1.3.3 and 1.3.8 to 1.3.11, 2019 8. 7 / 10 A 16-year-old with no menstrual periods is markedly short for her family, has a broad chest and widely spaced nipples, and has not developed breasts. FSH is markedly elevated on repeat testing; pelvic ultrasound shows small streak gonads. What is the most likely underlying diagnosis? Show answer **Answer: D.** Turner syndrome with gonadal dysgenesis. **Why:** This presentation indicates primary ovarian insufficiency from gonadal dysgenesis. Short stature, absent breast development, raised FSH and streak gonads are characteristic of Turner syndrome. The elevated FSH indicates loss of ovarian feedback, and the streak gonads support gonadal dysgenesis. Mullerian agenesis usually preserves ovarian hormone production and breast development, while androgen insensitivity usually presents with breast development and sparse pubic hair. The clinical and laboratory findings therefore distinguish Turner syndrome from both alternatives. * **A.** Androgen insensitivity usually presents with breast development and sparse pubic hair, not absent breast development with high FSH. * **B.** PCOS does not explain absent pubertal development, short stature and hypergonadotrophic ovarian failure. * **C.** Mullerian agenesis typically has normal ovarian function and secondary sexual characteristics despite absent uterus. Sources: NHS, Starting your periods; NICE CKS, Amenorrhoea 9. 8 / 10 A 17-year-old has never menstruated. Breast and pubic hair development are normal. She reports monthly cramping lower abdominal pain. Examination shows a tense, bluish bulge at the vaginal introitus; no vaginal opening is visible. What is the most likely cause of her primary amenorrhoea? Show answer **Answer: A.** Imperforate hymen causing outflow obstruction. **Why:** An imperforate hymen can obstruct menstrual flow after otherwise normal pubertal development, producing cyclic pain and a bulging hymen. Turner syndrome and hypothalamic amenorrhoea do not explain the local examination finding. She needs prompt gynaecological assessment. * **B.** Turner syndrome usually causes gonadal insufficiency and impaired pubertal development, not a bulging hymen with cyclic pain. * **C.** PCOS is not the best explanation for primary amenorrhoea with cyclic pain and a visible outflow obstruction. * **D.** Hypothalamic amenorrhoea does not cause retained blood or a bulging hymen. Sources: NHS, Starting your periods, reviewed 2026; NICE CKS, Amenorrhoea 10. 9 / 10 A 29-year-old primigravida attends her booking appointment at 10 weeks' gestation. She has a history of type 1 diabetes mellitus and chronic kidney disease. Her blood pressure is 125/80 mmHg and urinalysis shows trace protein. What is the most appropriate prophylactic treatment to reduce her risk of developing pre-eclampsia? Show answer **Answer: A.** Aspirin 150 mg daily, starting from 12 weeks' gestation until birth **Why:** NICE guideline NG133 outlines risk factors for pre-eclampsia. High-risk factors include chronic hypertension, hypertensive disease during a previous pregnancy, chronic kidney disease, autoimmune disease (like SLE or antiphospholipid syndrome), and type 1 or type 2 diabetes. Women with >= 1 high-risk factor should be prescribed Aspirin 75-150 mg daily from 12 weeks' gestation until the birth of the baby. * **B.** Labetalol is an antihypertensive used to treat gestational or chronic hypertension, not a prophylactic agent for pre-eclampsia in a patient with normal booking BP. * **C.** LMWH is used for VTE thromboprophylaxis, not for pre-eclampsia prevention. * **D.** Aspirin should be started at 12 weeks' gestation, not before, and 150 mg is the standard dose recommended by NICE to optimize prevention. Sources: NICE NG133 11. 10 / 10 A 35-year-old with possible premature ovarian insufficiency asks whether an AMH blood test is needed to confirm the diagnosis. What is the role of anti-Mullerian hormone testing? Show answer **Answer: D.** Do not routinely use AMH to diagnose premature ovarian insufficiency **Why:** Do not routinely use anti-Mullerian hormone testing to diagnose premature ovarian insufficiency. In people under 40, use the clinical history, symptoms and FSH results from two samples 4 to 6 weeks apart. * **A.** NICE NG23 advises against routine AMH testing to diagnose premature ovarian insufficiency. * **B.** NICE NG23 does not recommend routine AMH testing for this diagnosis. * **C.** The recommended diagnostic approach uses symptoms and two elevated FSH samples, not routine AMH. Sources: NICE NG23 recommendations 1.7.2 and 1.7.4 ## 1645 more questions like these are waiting in UK.med Timed practice, spaced repetition and AI clinical simulations that grade you like an examiner. Free to start. 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